Working in the United States of America
General Information
Number of occupational therapists in the United States of America
146,074
Main language(s) spoken in the United States of America
English
Other languages commonly spoken in the United States of America
Spanish, Chinese, Tagalog, Vietnamese, Arabic
Registration
Occupational therapists are required to register with a federal/national organisation to practice
Required
National Board for Certification in Occupational Therapy (NBCOT) is available at https://www.nbcot.org/ (External) ↗
To work as an Occupational Therapist, you must pass a national exam to obtain the qualification certificate.
To work as an Occupational Therapist, you must pass a national exam to obtain the qualification certificate.
Occupational therapists are required to register with a state/regional organisation to practice
Required
https://www.aota.org/-/media/corporate/files/secure/advocacy/licensure/stateregs/qualifications/qualifications-and-licensure-requirements-ot.pdf (External) ↗
Licensing requirements vary by state or territory.
Licensing requirements vary by state or territory.
It is compulsory to join the American Occupational Therapy Association Inc in order to practice as an occupational therapist
No
Practicing Requirements
Graduation from a WFOT approved programme is required to register to practice
Yes
https://www.nbcot.org (External) ↗
Occupational therapists and occupational therapy assistants must graduate from a program with accreditation from the Accreditation Council for Occupational Therapy Education (ACOTE) if education was in the US, and if from another country, a WFOT accredited program.
For information about ACOTE standards for Occupational Therapist education programs, and Occupational Therapy Assistant education programs, go to https://www.acoteonline.org (External) ↗
Occupational therapists and occupational therapy assistants must graduate from a program with accreditation from the Accreditation Council for Occupational Therapy Education (ACOTE) if education was in the US, and if from another country, a WFOT accredited program.
For information about ACOTE standards for Occupational Therapist education programs, and Occupational Therapy Assistant education programs, go to https://www.acoteonline.org (External) ↗
Language(s) that are required for occupational therapists to practice
English
Some job locations may ask for clinicians to speak multiple languages based on area and need.
Additional requirements for occupational therapists to practice
Note that initial NBCOT certification AND current state licensure are required for practice. Professional liability insurance is recommended and should be explored with employer.
Employment Opportunities
Occupational therapy is recognised as a shortage occupation
Yes
Yes, according to the US Bureau of Labor Statistics and it is a growing and in demand field.
Sources of information for occupational therapist employment opportunities
Employment is available in many different areas of occupational therapy practice. Job advertisements and career information are published online by AOTA on OTJoblink: http://www.otjoblink.org/ (External) ↗ Employment advertisements are also published in AOTA's practice magazine, OT Practice. You should make inquiries about employment to the specific employer in the job advertisement. Salaries, benefits, and specifics of employment (e.g., experience required, days and hours of employment, travel required, etc.) vary and are determined by the employer. AOTA does not make placement arrangements.
Immigration
Immigration regulations or visa requirements to practice
The U.S. Department of Homeland Security issues visas to foreign nationals wishing to work in the United States. In most cases, this will be a category H1B temporary work visa. For further details about Health Care Worker Certification, visit the U.S. Department of Homeland Security website.You must get a visa certificate before applying for a visa. Two organisations are authorised to provide visa certification. National Board for Certification in Occupational Therapy (NBCOT), Visa Credential Verification Certificate (VCVC) https://www.aota.org/Practice/Manage/Intl/WorkinUS.aspx (External) ↗
Occupational Therapy Assistants
Occupational therapy assistants exist in the United States of America
Yes
Number of occupational therapy assistants in the United States of America
53,624
American Occupational Therapy Association Inc has a membership category for occupational therapy assistants
Yes
It is compulsory to join the American Occupational Therapy Association Inc in order to practice as an occupational therapy assistant
No
Occupational therapy assistants require formal training in occupational therapy to work as such in the United States of America
Yes
Please visit www.acoteonline.org to learn more about the OTA programs and degree levels. OTAs can earn an Associate's or Bachelor's Degree to become and OTA. Then, once graduated from an ACOTE approved program, the OTA needs to take the certification exam, please visit www.nbcot.org.
Occupational therapy assistants need to register with a federal/national organisation to practice in the United States of America
Yes
Note that initial NBCOT certification AND current state licensure are required for practice. Professional liability insurance is recommended and should be explored with employer.
Occupational therapy assistants need to register with a state/regional organisation to practice in the United States of America
Yes
https://www.aota.org/-/media/corporate/files/secure/advocacy/licensure/stateregs/qualifications/qualifications-and-licensure-requirements-ot.pdf (External) ↗
Licensing requirements vary by state or territory.
Licensing requirements vary by state or territory.
Disclaimer: This information was provided by American Occupational Therapy Association Inc and was last updated on 14th July 2025. WFOT is not liable for any inaccuracies, omissions, or changes in the information provided. This information is intended as a guide and should be independently verified before making any decisions.
Definition of Occupational Therapy in the United States of America
American Occupational Therapy Association Inc's definition of occupational therapy in own language
Definition of Occupational Therapy Practice for the AOTA Model Practice Act
The practice of occupational therapy means the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of participation in roles and situations in home, school, workplace, community, and other settings. Occupationaltherapyservicesare provided for the purpose of promoting health and wellness and to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy addresses the physical, cognitive, psychosocial, sensory, and other aspects of performance in a varietyof contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
The practice of occupational therapy includes:
A. Methods or strategies selected to direct the process of interventions such as:
1. Establishment, remediation, or restoration of a skill or ability that has not yet developed or is impaired. 2. Compensation, modification, or adaptation of activity or environment to enhance performance.
3. Maintenance and enhancement of capabilities without which performance in everyday life activities would decline.
4. Health promotion and wellness to enable or enhance performance in everyday life activities. 5. Prevention of barriers to performance, including disability prevention.
B. Evaluation of factors affecting activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:
1. Client factors, including body functions (such as neuromuscular, sensory, visual, perceptual, cognitive) and body structures (such as cardiovascular, digestive, integumentary, genitourinary systems).
2. Habits, routines, roles, and behavior patterns.
3. Cultural, physical, environmental, social, and spiritual contexts and activity demands that affect performance.
4. Performance skills, including motor, process, and communication/interaction skills.
C. Interventions and procedures to promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:
1. Therapeutic use of occupations, exercises, and activities.
2. Training in self-care, self-management, home management, and community/work reintegration.
3. Development, remediation, or compensation of physical, cognitive, neuromuscular, sensory functions and behavioral skills.
4. Therapeutic use of self, including one’s personality, insights, perceptions, and judgments, as part of the therapeutic process.
5. Education and training of individuals, including family members, caregivers, and others. 6. Care coordination, case management, and transition services.
7. Consultative services to groups, programs, organizations, or communities.
8. Modification of environments (home, work, school, or community) and adaptation of processes, including the application of ergonomic principles.
9. Assessment, design, fabrication, application, fitting, and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices.
10. Assessment, recommendation, and training in techniques to enhance functional mobility, including wheelchair management.
11. Driver rehabilitation and community mobility.
12. Management of feeding, eating, and swallowing to enable eating and feeding performance.
13. Application of physical agent modalities, and use of a range of specific therapeutic procedures (such as wound care management; techniques to enhance sensory, perceptual, and cognitive processing; manual therapy techniques) to enhance performance skills.
Adopted by the Representative Assembly 5/21/04 (Agenda A11, Charge 60)
The practice of occupational therapy means the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of participation in roles and situations in home, school, workplace, community, and other settings. Occupationaltherapyservicesare provided for the purpose of promoting health and wellness and to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy addresses the physical, cognitive, psychosocial, sensory, and other aspects of performance in a varietyof contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
The practice of occupational therapy includes:
A. Methods or strategies selected to direct the process of interventions such as:
1. Establishment, remediation, or restoration of a skill or ability that has not yet developed or is impaired. 2. Compensation, modification, or adaptation of activity or environment to enhance performance.
3. Maintenance and enhancement of capabilities without which performance in everyday life activities would decline.
4. Health promotion and wellness to enable or enhance performance in everyday life activities. 5. Prevention of barriers to performance, including disability prevention.
B. Evaluation of factors affecting activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:
1. Client factors, including body functions (such as neuromuscular, sensory, visual, perceptual, cognitive) and body structures (such as cardiovascular, digestive, integumentary, genitourinary systems).
2. Habits, routines, roles, and behavior patterns.
3. Cultural, physical, environmental, social, and spiritual contexts and activity demands that affect performance.
4. Performance skills, including motor, process, and communication/interaction skills.
C. Interventions and procedures to promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:
1. Therapeutic use of occupations, exercises, and activities.
2. Training in self-care, self-management, home management, and community/work reintegration.
3. Development, remediation, or compensation of physical, cognitive, neuromuscular, sensory functions and behavioral skills.
4. Therapeutic use of self, including one’s personality, insights, perceptions, and judgments, as part of the therapeutic process.
5. Education and training of individuals, including family members, caregivers, and others. 6. Care coordination, case management, and transition services.
7. Consultative services to groups, programs, organizations, or communities.
8. Modification of environments (home, work, school, or community) and adaptation of processes, including the application of ergonomic principles.
9. Assessment, design, fabrication, application, fitting, and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices.
10. Assessment, recommendation, and training in techniques to enhance functional mobility, including wheelchair management.
11. Driver rehabilitation and community mobility.
12. Management of feeding, eating, and swallowing to enable eating and feeding performance.
13. Application of physical agent modalities, and use of a range of specific therapeutic procedures (such as wound care management; techniques to enhance sensory, perceptual, and cognitive processing; manual therapy techniques) to enhance performance skills.
Adopted by the Representative Assembly 5/21/04 (Agenda A11, Charge 60)
Definition date: September 2007
Publications
OT Practice
This premiere professional magazine features the latest hot topics and emerging practice areas—everything from hands-on techniques to legislative issues, career advice, news, and job opportunities—for occupational therapy practitioners and students.
American Journal of Occupational Therapy
The American Journal of Occupational Therapy (AJOT) is an official publication of the American Occupational Therapy Association (AOTA), which represents the professional interests and concerns of more than 230,000 occupational therapists, assistants, and students nationwide.
Education Programmes
WFOT Approved Programmes in the United States of America
327